RGU has the opportunity to fill a need in the local community
With the recent introduction of their new associate, Dr. J. Salvador Saldivar, M.D., M.P.H., F.A.C.O.G., F.A.C.S., Rio Grande Surgical Group (a.k.a. Rio Grande Urology) seeks to become one of the few multispecialty cancer care centers in the region.
In addition to treating advanced prostate cancer, RGU’s addition of Dr. Saldivar’s specialty in gynecologic oncology means the RGU Cancer Center will be able to offer cancer care to both male and female patients right here in El Paso. Previously, some specialized therapies were only available in other cities, such as San Antonio or Houston. RGU’s Radiation Center, which is on the same campus, recently acquired an HDR (high dose radiation) machine to offer this technology needed to treat some gynecologic cancers.
The Vision for an El Paso Cancer Center
Jeffrey M. Spier, M.D., Managing Partner at Rio Grande Urology, begin talking to his partners at RGU about his vision of establishing an RGU Cancer Center a couple of years ago. It has been his goal to not only offer comprehensive cancer services to the urology patients at RGU, but also to create a local center for patients with other types of cancer as well.
“They have radiation technology,” says Dr. Saldivar. “And they have Dr. Calvin Han working there to do it.” Dr. Han is a board certified radiation oncologist and also the head of the RGU Radiation Center. “My vision is to be part of creating a cancer center here in El Paso with a special focus on the gynecologic cancer patient,” explains Dr. Saldivar. “It has been tried in the past, but there is not a true multidisciplinary cancer center in El Paso.”
“I know we are capable of keeping that patient who wants to go to Houston and offering quality care to them right here,” says Dr. Spier. “I’m very excited about the future of medicine where we give patients high-quality, local choices with an integrated model.”
The need for treating cancer patients is especially acute in the border areas, where a lack of access to quality medical care is often a barrier to early detection, prevention, and treatment. According to the American Cancer Society, cancer is the leading cause of death for Hispanics, and it comes in second only to heart disease for non-Hispanics.
Dr. Saldivar knows this all too well. One of his defining moments as a physician was when a 34 year-old female patient succumbed to cervical cancer, a cancer that can be prevented with screening.
“It was one of those times in residency where you wish you could have done something earlier,” he explains. “And her issue, as with many of our cervical cancer patients here on the border, was access to health care. Sometimes, it’s not even that. Maybe they missed their exams and their Pap smears and don’t come in for whatever reason. They eventually end up with advanced cervical cancer, and they succumb to their disease.”
Meeting the Need For a Multidisciplinary Cancer Center
Urologists are unique in that they work better in a group than individually, which is the future of medicine, according to Dr. Spier. LUGPA (Large Urology Group Practice Association) has created protocols to improve patient care and outcomes. One of those is to provide care in a large group where physicians can begin specializing and then working as a team.
Because these protocols are already in place, RGU is uniquely suited to develop a multidisciplinary cancer center. The long-term plan for RGU Cancer Center is to offer surgical treatment, radiation therapy, and chemotherapy, all under one roof.
“Part of the vision would be to have a multi-specialty center where we have other physicians,” explains Dr. Spier. “Medical oncology, breast surgeons, and others will be included. We already have a medical oncologist who is available to consult.”
Collaboration and streamlining patient care are two benefits of the multidisciplinary model. There are no phone calls or waiting for charts when consulting on a patient’s care.
“I walk into Dr. Han our radiation oncologist’s office and introduce my patient,” says Dr. Spier. “There is nothing better than face to face interaction with a colleague.”
The goal would be to treat all types of cancers: gynecologic, urologic, and eventually breast cancer and others all under one institution. Although the clinic will most likely continue to see a majority of urology patients, specializing in urologic cancers like kidney and bladder cancer, many of the therapies are the same.
Dr. Spier says, “Some of the oral oncolytics are available on-campus. Immunotherapy (provenge) is also available oncampus. Xofigo, which is a radionuclide that helps prevent bone disease, is available on-campus. We have all the latest and greatest treatment modalities where the patient doesn’t have to go elsewhere. We feel we are the experts in advanced prostate care.”
Dr. Saldivar also brings a surgical expertise to the Cancer Center through his specialization in robotic surgery, minimally invasive laparoscopy and radical surgical treatment of ovarian cancer called optimal cytoreductive surgery. This procedure involves debulking as much of the tumor as is visible, which may also involve removing portions of the liver and spleen, as well as the covering of the abdomen called the peritoneum, in a process called peritoneal stripping.
In many cases of advanced ovarian cancer, where aggressive treatment is warranted, this type of surgery has a very positive effect on survival rates in certain patients.
On the other hand, robotic surgery offers the opportunity for less invasive treatment when possible, especially in endometrial cancer, the most common gynecologic cancer in the U.S.
As Dr. Saldivar explains, “When I look at a cancer patient, the first thing that goes through my mind is, ‘Can I take my cancer patient, make small incisions to remove her disease, and enable her to get out of the hospital the next day?’ This is often a better option versus making a large incision with traditional surgery that often requires numerous days in the hospital.”
Surgeries that once required long recovery times can now often be performed on an outpatient basis with excellent results because of the advances in robotic surgery.
Making a Difference for El Paso Cancer Patients
Having Dr. Saldivar join the practice is the next step in achieving Dr. Spier’s vision for a cancer center in El Paso. More specialties will be added as new physicians join the group, as well as general surgery, which Dr. Spier feels would be a fantastic addition to a multi-specialty cancer center.
“It is our vision and we see the potential for growth to make this center a place El Paso can be proud of,” says Dr. Spier. “The follow-up will be a lot more seamless for patients than having to travel back and forth to another city.” Patient care and communication will also be enhanced.
In addition to the new treatments RGU Cancer Center will offer, Dr. Saldivar is excited about the new technologies available in early detection and personalized medicine through genetic testing.
“There are hereditary cancer syndromes that incur a high risk of breast and ovarian cancer other than just the well-known BRCA 1 & 2 gene mutations” says Dr. Saldivar. “We are discovering new gene mutations that promote cancer in other organs, so now there are multi-gene panel tests to detect them. Once detected in patients, we can plan preventive and screening algorithms to reduce the risks of cancers. I am sure there will be more discoveries in the future. Personalized medicine is an exciting field.”
All of this innovation serves the goal of saving lives and elevating the quality of care for the patients and survivors of these cancers.
One of the most rewarding parts of this new venture is offering local cancer treatment to patients who previously would have had to travel to MD Anderson or the Mayo clinic. According to Dr. Saldivar, it’s the privilege to care for them, and that he can make a difference in his patients’ lives, that keeps him humble—and driven to continue to seek ways to improve the care and quality of life for his patients with gynecologic cancer.
“We have seen that a lot of advanced prostate cancer patients are managed by two or three physicians,” adds Dr. Spier. “My vision is to simplify the process and have a physician champion who can manage the process and follow the patient in a way that doesn’t require duplication of processes. So the patient feels like they are part of an advanced center that is going to watch them the rest of their lives and take care of them the right way.”
RGU is now one step closer to that vision and is already making a big difference in El Paso’s cancer care community.